High-income countries experience a stark reduction in life expectancy for individuals diagnosed with diabetes at younger ages, according to a comprehensive study spanning over 19 nations and more than 23 million person-years of data. The Lancet published a groundbreaking study that examined the association between the age of diabetes diagnosis and its impact on life expectancy.
The prevalence of type 2 diabetes has been steadily increasing worldwide due to factors such as obesity, dietary choices, and physical activity levels. In 2021, an estimated 537 million adults globally were living with diabetes, with a noticeable trend of diagnoses occurring at younger ages. This study aimed to provide a comprehensive analysis of how age at diabetes diagnosis relates to all-cause mortality, cause-specific mortality, and reductions in life expectancy, focusing primarily on high-income countries.
The research team analyzed individual records from an impressive 97 long-term, prospective cohorts, involving a staggering 1,515,718 participants over a cumulative follow-up period of 23.1 million person-years. The results of the study demonstrated a compelling dose-response relationship, indicating that earlier age at diabetes diagnosis was associated with a significantly higher risk of all-cause mortality. On average, for every decade younger an individual was diagnosed with diabetes, their life expectancy reduced by approximately 3 to 4 years.
To illustrate the impact, for individuals reaching the age of 50 years, those diagnosed with diabetes at age 30 experienced a staggering 14-year reduction in life expectancy compared to individuals without diabetes. Those diagnosed at age 40 faced a 10-year reduction, and those diagnosed at age 50 faced a 6-year reduction.
Notably, the study found that the most substantial associations with earlier age at diabetes diagnosis were related to vascular conditions, including myocardial infarction and stroke, as well as other non-neoplastic causes of death, such as respiratory, neurological, infectious diseases, and external causes. Additionally, the research indicated that the reduction in life expectancy associated with diabetes was slightly greater for women than for men.
The study’s findings underscore the pressing need to prioritize the development and implementation of interventions that can prevent or delay the onset of diabetes, particularly as the prevalence of diabetes among younger adults continues to rise globally. The observed higher hazard ratios for mortality with earlier diabetes diagnosis suggest that the relative impact of diabetes is most pronounced at ages when the underlying mortality risk in the general population is lowest.
This aligns with previous research on cardiovascular risk factors and underscores the significance of addressing diabetes among younger populations. It’s hypothesized that individuals diagnosed with diabetes at younger ages may exhibit more aggressive phenotypes characterized by higher body mass index, blood pressure, proatherogenic lipid levels, and faster deterioration in glycemic control, contributing to premature mortality.
The study also emphasized the importance of early detection through screening and intensive glucose management as potential avenues for mitigating the long-term complications associated with type 2 diabetes. While the study offers crucial insights into the relationship between age at diabetes diagnosis and life expectancy, it also acknowledges certain limitations, including variations in how diabetes was defined across contributing studies and the absence of information regarding the pathophysiological subtype of diabetes.
In conclusion, the study’s findings emphasize the substantial impact of age at diabetes diagnosis on life expectancy, underscoring the need for proactive measures to prevent or delay the onset of diabetes among younger individuals and intensify the treatment of risk factors in this population. This research provides valuable insights into the long-term consequences of early diabetes diagnosis and highlights the importance of public health initiatives and clinical interventions to address this pressing global health issue.
